Hasegawa Masatoshi, Kojima Masaru, Shioya Mariko, Tamaki Yoshio, Saitoh Jun-ichi, Sakurai Hideyuki, Kitamoto Yoshizumi, Suzuki Yoshiyuki, Niibe Hideo, Nakano Takashi
Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan.
Int J Radiat Oncol Biol Phys. 2003 Sep 1;57(1):172-6. doi: 10.1016/s0360-3016(03)00506-6.
To analyze the results of radiotherapy (RT) for malignant lymphoma of the orbit and to evaluate them compared with the World Health Organization (WHO) classification published in 2001.
The data from 29 patients with malignant lymphoma of the orbit treated with RT at Gunma University Hospital between 1978 and 2001 were retrospectively analyzed. Pathologic slides from 23 cases were available and were reviewed by a hematopathologist according to the WHO classification. The original and reviewed diagnoses, patient characteristics, treatment results, and complications were analyzed. In principle, patients with low-grade or indolent lymphoma were treated with RT alone, using 30 Gy as the tumor dose. Survival data were calculated using the Kaplan-Meier method.
One case that proved to be a pseudotumor was excluded from evaluation. Of the 28 cases, 25 were Stage IAE, 1 was Stage IIAE, and 2 were Stage IVAE. The median follow-up was 71 months. According to the original classification and the Working Formulation, the 5- and 10-year overall survival rate of patients with low-grade lymphoma was 94% and 73%, respectively. The corresponding rates for those with intermediate-grade lymphoma were 67% and 67% (p = 0.15). In contrast, the WHO classification showed a significant difference in the survival curves. The 5- and 10-year overall survival rate of patients with mucosa-associated lymphoid tissue (MALT) lymphoma was 100% and 88%, respectively; for diffuse large B-cell patients, the rates were both 0% (p < 0.001). In patients with MALT lymphoma, one local and four distant relapses developed; two of them >10 years after initial treatment. All of the relapsed MALT lymphomas were controlled by salvage therapy.
Excellent local control and survival can be achieved for patients with orbital MALT lymphoma using RT alone. A precise histopathologic diagnosis using the WHO classification and long-term follow-up for >10 years is recommended.
分析眼眶恶性淋巴瘤的放射治疗（RT）结果，并与2001年发布的世界卫生组织（WHO）分类进行比较评估。
回顾性分析1978年至2001年期间在群马大学医院接受RT治疗的29例眼眶恶性淋巴瘤患者的数据。有23例患者的病理切片可供使用，血液病理学家根据WHO分类对其进行了复查。分析了原始诊断和复查诊断、患者特征、治疗结果及并发症。原则上，低级别或惰性淋巴瘤患者仅接受RT治疗，肿瘤剂量为30 Gy。使用Kaplan-Meier方法计算生存数据。
1例被证实为假瘤的病例被排除在评估之外。在这28例病例中，25例为IAE期，1例为IIAE期，2例为IVAE期。中位随访时间为71个月。根据原始分类和工作方案，低级别淋巴瘤患者的5年和10年总生存率分别为94%和73%。中级淋巴瘤患者的相应生存率分别为67%和67%（p = 0.15）。相比之下，WHO分类显示生存曲线存在显著差异。黏膜相关淋巴组织（MALT）淋巴瘤患者的5年和10年总生存率分别为100%和88%；弥漫性大B细胞患者的生存率均为0%（p < 0.001）。在MALT淋巴瘤患者中，发生了1例局部复发和4例远处复发；其中2例在初始治疗10年后复发。所有复发性MALT淋巴瘤均通过挽救治疗得到控制。
眼眶MALT淋巴瘤患者仅使用RT即可实现良好的局部控制和生存。建议使用WHO分类进行精确的组织病理学诊断，并进行超过10年的长期随访。
